Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques—a randomized controlled study
Abstract Understanding the sites of pharyngeal collapse is mandatory for surgical treatment decision-making in obstructive sleep-apnea-hypopnea syndrome patients. Drug-induced sleep endoscopy (DISE) allows for the direct observation of the upper airway during sedative-induced sleep. In order to re-create snoring and apnea patterns related to a spontaneous sleep situation, the authors used a target-controlled infusion (TCI) sleep endoscopy (DISE-TCI), comparing this technique to conventional DISE, in which sedation was reached by a manual bolus injection. The authors conducted a prospective, randomized, unicenter study. The apneic event observation and its correlation with pharyngeal collapse patterns is the primary endpoint; secondary endpoints are defined as stability and safety of sedation plans of DISE-TCI technique. From January 2009 to June 2009, 40 OSAHS patients were included in the study and randomized allocated in two groups: the bolus injection conventional DISE group and the DISE-TCI group. We recorded the complete apnea event at the oropharynx and hypopharynx levels in 4 patients of the conventional DISE group (20%) and in 17 patients of the DISE-TCI group (85%) (P < 0.0001). Two patients needed oxygen in the conventional DISE group because of severe desaturation that resulted from the first bolus of propofol (1 mg/kg) (P = 0.4872 ns). We recorded the instability of the sedation plan in 13 patients from the conventional DISE group (65%) and 1 patient from the DISE-TCI group (5%) (P = 0.0001). Our results suggest that the DISE-TCI technique should be the first choice in performing sleep endoscopy because of its increased accuracy, stability and safety..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2010 |
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| Erschienen: |
2010 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:268 |
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| Enthalten in: |
European archives of oto-rhino-laryngology and head & neck - 268(2010), 3 vom: 02. Sept., Seite 457-462 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
De Vito, Andrea [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Obstructive sleep-apnea-hypopnea syndrome |
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| RVK: |
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| Anmerkungen: |
© Springer-Verlag 2010 |
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| doi: |
10.1007/s00405-010-1376-y |
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| PPN (Katalog-ID): |
OLC2056338548 |
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| 520 | |a Abstract Understanding the sites of pharyngeal collapse is mandatory for surgical treatment decision-making in obstructive sleep-apnea-hypopnea syndrome patients. Drug-induced sleep endoscopy (DISE) allows for the direct observation of the upper airway during sedative-induced sleep. In order to re-create snoring and apnea patterns related to a spontaneous sleep situation, the authors used a target-controlled infusion (TCI) sleep endoscopy (DISE-TCI), comparing this technique to conventional DISE, in which sedation was reached by a manual bolus injection. The authors conducted a prospective, randomized, unicenter study. The apneic event observation and its correlation with pharyngeal collapse patterns is the primary endpoint; secondary endpoints are defined as stability and safety of sedation plans of DISE-TCI technique. From January 2009 to June 2009, 40 OSAHS patients were included in the study and randomized allocated in two groups: the bolus injection conventional DISE group and the DISE-TCI group. We recorded the complete apnea event at the oropharynx and hypopharynx levels in 4 patients of the conventional DISE group (20%) and in 17 patients of the DISE-TCI group (85%) (P < 0.0001). Two patients needed oxygen in the conventional DISE group because of severe desaturation that resulted from the first bolus of propofol (1 mg/kg) (P = 0.4872 ns). We recorded the instability of the sedation plan in 13 patients from the conventional DISE group (65%) and 1 patient from the DISE-TCI group (5%) (P = 0.0001). Our results suggest that the DISE-TCI technique should be the first choice in performing sleep endoscopy because of its increased accuracy, stability and safety. | ||
| 650 | 4 | |a Sleep endoscopy | |
| 650 | 4 | |a Obstructive sleep-apnea-hypopnea syndrome | |
| 650 | 4 | |a Target-controlled infusion | |
| 700 | 1 | |a Agnoletti, Vanni |4 aut | |
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| 700 | 1 | |a Piraccini, Emanuele |4 aut | |
| 700 | 1 | |a Criscuolo, Armando |4 aut | |
| 700 | 1 | |a Corso, Ruggero |4 aut | |
| 700 | 1 | |a Campanini, Aldo |4 aut | |
| 700 | 1 | |a Gambale, Giorgio |4 aut | |
| 700 | 1 | |a Vicini, Claudio |4 aut | |
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